Use of tracheloscopy and directed biopsy for evaluating cervical involvement in endometrial carcinoma

Accurate assessment of cervical involvement in endometrial carcinoma (stage II) is often difficult. The value of tracheloscopy as a possible method for improving accuracy was assessed. One hundred one patients with endometrial carcinoma were studied; 28 were suspected of having cervical involvement on endocervical curettage, and 26 were evaluable. Only five patients were documented to have cervical involvement using tracheloscopy. This finding suggests that there is general overtreatment of patients with false-positive endocervical curettage. However, a definitive statement concerning the incidence of stage II disease in the series cannot be made because many patients received traditional preoperative radiation therapy, which may have eradicated intracervical disease missed by tracheloscopy, therefore falsely confirming stage 1 disease on history from subsequent hysterectomy specimens.